Article in Japanese

A case of pulmonary Mycobacterium kansasii disease after conventional Glenn procedure for congenital heart disease

Hiro NAKAO¹⁾, Munehiro FURUICHI²⁾, Isao MIYAIRI²⁾

This study reported a case of pulmonary Mycobacterium kansasii disease in a cyanotic patient after an operation for congenital heart disease. The patient was a 26-year-old male who had conventional Glenn and central shunt procedures for the right single cardiac ventricle at 2 and 16 years of age, respectively. He contracted infectious endocarditis at 17 years of age. He visited this hospital over a period of one year for productive cough and intermittent fever that did not respond to oral antibiotics prescribed elsewhere. Eventually, chest imaging revealed cavitary nodules in the right upper lung lobe, and he was admitted to this hospital on the same day with suspicion of infectious endocarditis or pulmonary infection. Negative results were obtained from 11 sets of blood culture, tuberculosis specific interferon-gamma-releasing assay, and Ziehl-Neelsen stain. However, acid-fast culture of sputum cultivated M. kansasii and he was diagnosed with pulmonary M. kansasii disease. He recovered after a one-year course of three antituberculosis drugs; isoniazid, rifampicin, and ethambutol.
With improved survival rate from congenital heart disease and the progress of diagnostic methods for nontuberculous mycobacterial infection, the rate of nontuberculous mycobacterial infection complicating congenital heart disease might increase. Therefore, physicians need to consider mycobacterial infection as a differential diagnosis of respiratory episodes in patients with congenital heart disease.

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1) Department of General Pediatrics, National Center for Child Health and Development
2) Division of Infectious Disease, National Center for Child Health and Development

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Received	March 16, 2016
Accepted	June 27, 2016

28 (3)：153─158,2016